April 16, 2007

Washington, D.C., Council Members Propose Measure To Require Girls Entering Sixth Grade To Receive HPV Vaccination

Washington, D.C., City Council Members Mary Cheh (D) and independent David Catania on Tuesday proposed a bill that would require girls entering the sixth grade to receive Merck's human papillomavirus vaccine Gardasil, the Washington Post reports (Stewart/Stein, Washington Post, 1/10). Gardasil in clinical trials has been shown to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases. FDA in July 2006 approved the vaccine for sale and marketing to girls and women ages nine to 26, and CDC's Advisory Committee on Immunization Practices later that month voted unanimously to recommend that girls ages 11 and 12 receive the vaccine (Kaiser Daily Women's Health Policy Report, 1/9). According to the legislation, female students would be required to show proof of vaccination before enrolling in the sixth grade in District of Columbia Public Schools, unless their parent or legal guardian chose to "opt out" of the requirement. The bill does not specify the circumstances under which girls would be allowed an exemption. Catania said he is introducing the bill because federal funding is available so Medicaid beneficiaries and others who are uninsured or underinsured can be vaccinated at no cost. According to the Post, Catania also decided to propose the legislation in part because of the high cervical cancer incidence in the district, which the American Cancer Society reports is 13.5 cases per 100,000 females, compared with the national rate of 8.8 cases per 100,000 females. "With January being National Cervical Cancer Awareness Month, now is the perfect time for the [d]istrict to lead the nation in the fight against what is in essence a preventable disease," Catania said at the Council meeting. Stanley Gall of the American College of Obstetricians and Gynecologists said, "I think this makes perfect sense," adding, "There would certainly be a significant health benefit." Joseph Bocchini, chair of the American Academy of Pediatrics committee on infectious diseases, said, "I think it's too early. This is a new vaccine. It would be wise to wait until we have additional information about the safety of the vaccine." Iris Toyer, co-chair of Parents United for D.C. Public Schools, said whether to vaccinate girls with Gardasil is "really a decision between parents and doctors," adding that she understands the "intent" of the legislation, "but a lot of discussion must be done" (Washington Post, 1/10).

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